Human Rights Watch, the nonprofit that has for decades called attention to victims of war, famine, and political persecution around the world, is targeting US hospitals for has pushed millions of American patients into debt.
In a new report, published June 15, the group urges the government to take stronger action to protect Americans from nonprofit hospitals that bill and collect excessive debt, which the Foundation Human Rights Watch argues that it is systematically undermining patients’ human rights.
The report concludes: “Given the high rate of hospital-related medical debt in the United States, this system is clearly not working,” the report concluded, based on an ongoing investigation into medical debt. by KFF Health News and NPR.
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The report continues: “A tax-free subsidy model for privately run U.S. hospitals in the hope that they will increase access to hospital care for uninsured patients. and underinsurance have allowed abuses of medical billing and debt collection practices, and undermined human rights, including the right to health care.”
Nationwide, about 100 million people — or 41% of adults — have some form of healthcare debt, a KFF survey conducted for the KFF Health News-NPR project found. And while patient debt is being driven by a flurry of medical and dental bills, polls and studies show that hospitals are a major contributor.
The KFF poll found that about one-third of adults in the United States have medical debt to pay for hospitalization. Nearly half of them owed at least $5,000. About a quarter owe $10,000 or more.
Researcher Matt McConnell, the report’s author, said the scale of this crisis – unprecedented in rich nations – has forced Human Rights Watch to release a new report. “Historically, Human Rights Watch has been an organization focused on international human rights issues,” he said. “But in terms of medical debt, the US is really an exception. What you see is a system that privileges the few but creates huge barriers for people to access basic health rights.”
Hospital industry officials defend their work, citing the hospital’s broader work as helping the communities they serve. “As an industry, hospitals provide more benefits to their communities than any other in healthcare,” said Melinda Hatton, general counsel at the American Hospital Association. wrote in a response to the Human Rights Watch report.
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Federal law requires that private, tax-exempt hospitals – which make up more than half of the nation’s medical centers – provide free or discounted care to low-income patients. But reporting by KFF Health News and others has found that many hospitals make it difficult for patients.
At the same time, thousands of medical centers—including many tax-exempt—engage in aggressive debt collection tactics to pursue patients, including seizing patients’ wages, mortgaging their homes. or sell their debt to a third party for collection.
Overall, KFF Health News found that most of the approximately 5,100 public-service hospitals nationwide have a policy of using legal action or other aggressive tactics against patients. And 1 in 5 people will deny non-emergency care to debtors.
“Medical debt is engulfing many low- and working-class families while hospitals continue to benefit from a non-tax situation,” said Marceline White, executive director of the Maryland Economic Action Foundation. profits as they pursue families for medical debt. The advocacy group helped enact stricter rules to ensure hospitals in Maryland can access financial assistance more easily and restrict hospitals from engaging in some aggressive debt collection tactics, such as such as placing collateral in a patient’s home.
Similar efforts are underway in other states, including Colorado, New Mexico, New York, Oregon and Washington. But many patient and consumer advocates say stronger federal action is needed to expand patient protections.
The Human Rights Watch report — titled “In sheep’s clothing: America’s poorly regulated nonprofit hospitals undermine access to health care” — lists more than a dozen Recommendations. Including:
- Congress should pass legislation to ensure that hospitals provide at least the same amount of charity care as they receive from public subsidies.
- The IRS should establish uniform national standards for patient financial assistance eligibility in nonprofit hospitals. Currently, hospitals freely set their own standards, so there are widespread differences, causing confusion for patients.
- The Consumer Financial Protection Bureau, a federal watchdog, should crack down on debt collectors who fail to ensure that patients have been screened for financial assistance before being chased.
- The federal Centers for Medicare & Medicaid Services, which administers two huge public insurance programs, should penalize hospitals that do not provide adequate financial assistance to patients.
“Non-profit hospitals are contributing to medical debt and engaging in abusive billing and collection practices,” McConnell said. “The reason this continues to happen is the lack of clear guidelines and the federal government’s inadequate enforcement of existing regulations.”
KFF Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation not affiliated with Kaiser Permanente.
